Exploration of the elderly health self-efficacy and need of preventive rehabilitation medical service

• Main Authors: Yi-Fu Chen, 陳怡富
• Other Authors: Yan-I Chen
• Format: Others
• Language: zh-TW
• Online Access: http://ndltd.ncl.edu.tw/handle/89067860658818862520

碩士 === 元智大學 === 管理碩士在職專班 === 102 === Research Background and Purpose: With the elderly population accounting for 11.1% of the total population in 2012, Taiwan is to become an aging society. According to the World Health Organization, WHO, the lack of physical activity has become the fourth risk factor of global mortality. Statistics of the Health Promotion Administration, Ministry of Health and Welfare show that fall accidents are the second among the leading causes of death. Literatures show that incidences of falls among elderly account for 13.7%~34%. Among them, 37% of elderly have had repetitive falls, thus leading to extra healthcare costs. Literatures point out that about 50%-60% of elderly require rehabilitation, 30%-40% are aware they need rehabilitation, and only 10%-15% actually engage in rehabilitation. In order to gain an insight into elderly’s health self-efficacy, exercise habit, the intervention of rehabilitation medicine for health improvement, as well as their interactive relationship and factors affecting demand, the elderly’s demand for rehabilitation and rehabilitation service groups with potential needs are analyzed based on the results. Timely rehabilitation exercise intervention improves the physical function, reduces falls due to a lack of physical activity, and reduces healthcare and social costs arising from accidental falls. Research methods: The research framework covers discussions on factors affecting individuals’ access to healthcare services, with the “behavioral model for access to healthcare services” proposed by Anderson (1995) as the basis. People aged above 65 years old who have the ability to walk are adopted as the study participants. “Exercise habit”, “rehabilitation demand and willingness”, “predisposing factors”, and “demand factors” are explored to analyze elders’ exercise, body balance ability, and rehabilitation service demand. In addition, instructions on professional rehabilitation exercises as well as innovative and practical recommendations are further proposed to promote elderly exercise concepts and methods, thereby lowering elders’ accelerated degeneration of bodily functions due to a lack of exercise and reducing the burden of healthcare costs and social costs. Conclusion and Recommendations: With or without “exercise habit”, “demand for rehabilitation exercise instructions” and “instructions for attempting to engage in rehabilitation exercise” show a positive correlation. In particular, those with rehabilitation experiences have the tendency to confirm the effectiveness before trying. Those who have experienced falls or have reduced exercise in six months perceive a significant drop in stamina, but they perceive their health as good. The obvious gap between the two is worthy of further investigation. Those with the “walking stability” problem and those who are willing to try rehabilitation services provided by hospitals to improve walk stability make exercise a habit and hope to comply with home-based exercise prescriptions. The common characteristic of those not willing to try is that they have not experienced unsteady gait so far. Findings show that elders deem walking stability very important. However, the factors affecting elders’ participation in rehabilitation exercise instructions imparted to improve walking instability include: factors contributing to the tendency to access healthcare services, factors contributing to resource acquisition and use, factors contributing to individuals’ need to seek rehabilitation services. The policy-based recommendations are implemented to promote elders’ exercise habit and correct health awareness. As for recommendations for hospitals, in addition to rehabilitation through general instruments, the intervention of exercise instructions should be strengthened to improve the general public’s biased rehabilitation awareness. For patients with limited available time, the intervention of “instructor’s role” is adopted to improve elders’ walking stability problem.